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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often characterized as a focus on the practical aspects of designing a study, including the recruitment process and consent, adhering and the use of standard equipment.

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Pragmatic is a software developer that offers a broad range of casino games for online gambling platforms. Pragmatic's iGaming software is used by top operators and land based casinos. The company offers front-end site design tools, analysis tools and marketing, promotions, security, payment systems, customer service and bug-reporting. The company also provides security, high-quality graphics, games and security.

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A pragmatic trial that uses different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for pragmatic trials to be able to prove their validity and also helps reduce the chance of bias in the results. However excessive heterogeneity could lead to problems with the design of the trial.

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The goal of pragmatic trials is to replicate real-life scenarios and gain maximum validity externally. They are typically commissioned by practitioners and policy makers to guide their decision-making. They also provide a useful method of determining the causal relationship between an intervention and its outcomes. They should not, however, be used to replace explanation studies.

The pragmatism concept is controversial and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which validate the validity of a clinical or physiological hypothesis as well as pragmatic trials that inform policy and practice decisions. They also suggested a framework dubbed PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a practical study, including recruitment, design, implementation of the intervention, and follow-up.

There is an encouraging increase in the number pragmatic trials that are published. A recent Medline query using the keywords pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on Figure 2. This is a sign that the health sciences community is becoming more acquaint to the subject of pragmatics. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.